What happens to cells in hypernatremia?
When hypernatremia (of any etiology) occurs, cells become dehydrated. Either the osmotic load of the increased sodium acts to extract water from the cells or a portion of the burden of the body’s free water deficit is borne by the cell.
How do brain cells adapt to hypernatremia?
When hypernatremia lasts more than a few hours, brain cells generate new organic osmolytes. This leads to further water movement back into brain cells, restoring cell volume nearly to normal after about 3 days.
Why do cells shrink in hypernatremia?
Acute hypernatremia is associated with a rapid decrease in intracellular water content and brain volume caused by an osmotic shift of free water out of the cells.
What IV fluids are used to treat hypernatremia?
Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.
What happens if sodium is too high?
Hypernatremia typically causes thirst. The most serious symptoms of hypernatremia result from brain dysfunction. Severe hypernatremia can lead to confusion, muscle twitching, seizures, coma, and death.
What mechanism can cause hypernatremia?
Hypernatremia is usually caused by limited access to water or an impaired thirst mechanism, and less commonly by diabetes insipidus. Manifestations include confusion, neuromuscular excitability, hyperreflexia, seizures, and coma.
How do you treat hypernatremia?
Hypernatremia is treated with infusions of a solution of water containing 0.9% sodium chloride (0.9 grams NaCl /100 ml water), which is the normal concentration of sodium chloride in the blood plasma. The infusion is performed over many hours or days to prevent abrupt and dangerous changes in brain cell volume.
What is hypernatremia what are its symptoms?
The main symptom of hypernatremia is excessive thirst. Other symptoms are lethargy, which is extreme fatigue and lack of energy, and possibly confusion. Advanced cases may also cause muscle twitching or spasms.
What IV fluids to give for hypernatremia?
Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.